Device for positioning a patient{40 s shoulders during x-ray examination

ABSTRACT

Device for positioning shoulders of prone patient away from neck area to facilitate unobstructed X-ray examination of cervical spine comprises support with vertically disposed foot rest. Flexible elongate members are connected to support, and releasable attaching structure is provided at free end of each flexible elongate member for releasably attaching members to wrists of patient. Winding mechanism on support is connected to flexible elongate members for pulling free ends of members toward footrest. Releasable locking assembly associated with winding mechanism prevents withdrawal of flexible elongate members from support when locking assembly is engaged.

United States Patent Inventor .Iellrey P. Smith 2608 Whitman Drive, Wllmlngton, Del. H808 Appl. No. 9,355

Filed Feb. 6, I970 Patented Dec. 21, I971 DEVICE FOR POSITIONING A PATIENT'S SHOULDERS DURING X-RAY EXAMINATION 5 Claims, 7 Drawing Figs.

U.S. Cl 250/50, 250/54 Int.Cl .t ..G03b4I/I6 Field at Search 250/50, 54, 55', 269/328 Relerences (Zited UNITED STATES PATENTS (all 962 Robin 250/54 FOREIGN PATENTS 746,992 9/1944 Germany Primary Examiner-James W. Lawrence Assistant Examiner-C. E. Church AuorneyConnolly and Hut:

ABSTRACT: Device for positioning shoulders of prone patient away from neck area to facilitate unobstructed X-ray examination of cervical spine comprises support with vertically disposed foot rest. Flexible elongate members are connected to support, and releasable attaching structure is provided at free end of each flexible elongate member for releasably attaching members to wrists of patient. Winding mechanism on support is connected to flexible elongate members for pulling free ends of members toward footrest. Releasable locking assembly associated with winding mechanism prevents withdrawal of flexible elongate members from support when locking assembly is engaged.

PATENIED UEEZI an SHEET 2 OF 2 i-m mung};

DEVICE FOR POSITIONING A PATIENTS SI'IOULDERS DURING X-RAY EXAMINATION BACKGROUND OF THE INVENTION The present invention relates to a positioning device, and more particularly to a device for positioning a patient undergoing X-ray examination of the cervical spine.

As is well known to radiologists, when a supine lateral cervical spine examination is attempted, the shoulders of the patient undergoing the examination often present a major problem. While it is usually possible to obtain a good radiograph of the first five or six vertebrae, a lateral cervical must include all seven bodies as well as spinous processes. Too often a fracture or subluxation is overlooked because the lateral cervical radiograph is incomplete. Unless the shoulders of the patient are positioned away from the neck area it is impossible to produce a cervical radiograph of all seven vertebrae. In the past, a technician was required to stand at the patients feet and pull the arms downward until the shoulders were located away from the cervical spine. Often it required a strong person to pull the shoulders down far enough to see even the sixth vertebrae. An even more objectionable factor, when doing the positioning manually, is that the technician must remain in the radiographic room during X-ray exposure in order to be sure the shoulders of the patient are positioned out of the cervical field.

Accordingly, it is an object of the present invention to provide a relatively simple positioning device which functions in a highly satisfactory and beneficial manner to position a patient for unobstructed X-ray examination of the cervical spine.

SUMMARY OF THE INVENTION In accordance with the present invention, a device is pro vided for positioning at least one of the shoulders of a prone patient downwardly away from the neck area to facilitate unobstructed X-ray examination of the cervical spine. The positioning device comprises a support including a vertically disposed footrest. At least one flexible elongate member is connected at one end thereof to the support, and releasable attaching structure is secured to the free end of the flexible elongate member for releasably attaching the member to one of the wrists of the patient. A winding mechanism on the support is connected to the flexible elongate member for pulling the free end of the member toward the footrest. A releasable locking assembly associated with the winding mechanism prevents withdrawal of the flexible elongate member from the support when the locking assembly is engaged. With the patients feet engaging the footrest the arm and shoulder are pulled down out of the cervical field.

In a preferred embodiment of the present invention, the positioning device includes a pair of flexible elongate members. Each member is connected at one end thereofto the support. Releasable attaching structure is secured at the free end of each member, and the winding mechanism pulls the free end of each member toward the footrest.

The releasable attaching structure at the free end of each flexible elongate member may include an open-ended cuff with fasteners on the open portions of the cuff for releasably securing the cufi to the wrist of the patient. Additionally, a handhold can be secured to each flexible elongate member adjacent the free end thereof.

The preferred winding mechanism for the positioning device of the present invention includes a shaft journaled to the support with a ratchet wheel connected to the shaft for rotation therewith. A ratchet crank joumaled to the shaft has a pawl that engages the ratchet wheel to rotate the wheel and the shaft when the crank is manipulated The flexible elongate members are connected to the shaft so that rotation of the shaft through manipulation of the ratchet crank causes the members to wind around the shaft. The winding mechanism further includes a release element connected to the ratchet crank for disengaging the pawl from the ratchet wheel when when the release element is engaged.

The releasable locking assembly of the positioning device of the present invention includes a second ratchet wheel connected to the shaft for rotation therewith. A stationary pawl is biased into engagement with the second ratchet wheel for permitting rotation of the shaft only in the direction the crank rotates the shaft when the locking assembly is engaged. A release disengages the stationary pawl from the second ratchet wheel when the release is engaged.

BRIEF DESCRIPTION OF THE DRAWING Novel features and advantages of the present invention in addition to those mentioned above will become apparent to those skilled in the art from a reading of the following detailed description in conjunction with the accompanying drawing wherein:

FIG. I is a perspective view illustrating a positioning device according to the present invention and how the device is used;

FIG. 2 is an end elevational view of a positioning device according to the present invention;

FIG. 3 is a side elevational view of the positioning device shown in FIG. 2;

FIG. 4 is a top plan view of the positioning device shown in FIGS. 2 and 3;

FIG. 5 is a sectional view taken along line 55 of FIG. 2;

FIG. 6 is a sectional view taken along line 66 of FIG. 3; and

FIG. 7 is a fragmental perspective view illustrating the manner in which the flexible elongate members of the invention are connected to the rotatable shaft of the winding mechanism.

DETAILED DESCRIPTION OF THE INVENTION Referring in more particularity to the drawing, the various FIGS. illustrate a device 10 for positioning a patient undergoing X-ray examination. Specifically, the device 10 functions to position the shoulders of a prone patient downwardly away from the neck area to facilitate unobstructed X-ray examination of the cervical spine. The positioning device 10 comprises a support 12 including a vertically disposed footrest 14. A pair of flexible elongate strap members I6, [8 made of woven fabric or the like are each secured at one end thereof to the support 12. The free end of each strap member includes releasable attaching structure 20 for releasably securing the strap members to the wrists of the patient. A winding mechanism 22 on the support 12 is connected to the flexible elongate members I6, 18 for pulling the members towards the footrest I4. After the flexible elongate strap members to, I8 are tensioned by the winding mechanism, continued winding force causes the straps to pull the arms and shoulders of the patient downwardly away from the neck area toward the footrest 14. With the patients feet engaging the footrest [4, only the arms and shoulders of the patient are pulled downwardly.

As shown best in FIGS. 3 and 4, the releasable attaching structure 20 at the free end of each of the flexible elongate strap members 16, I8 enables the straps to be tightly secured to the wrists of the patient. Preferably, the attaching structure 20 takes the form of an open-ended cuff 24 made of flexible woven fabric or the like. The open end portions 26 of each cuff 24 include fasteners thereon for releasably securing the cuff to the wrist of the patient. In the embodiment of the invention illustrated in the drawing, the fastening structure 28 is Velcro with part of the Velcro anchored to the inside of one end portion 26 and the other Velcro part anchored to the outside of the other end portion 26. All that is required is that the open end portions 26 of each cuff 24 overlap and abut one another in order to releasably lock the cuff to the wrist of the patient. Each cuff is secured to the free end of one of the flexible elongate strap members I6, [8 by a bifurcated terminal strap portion 30. Preferably, a handhold 32 fabricated of rigid material like wood or metal is secured between the legs of the bifurcated terminal strap portion 30. In use, the patient undergoing the X-ray examination simply grasps the handholds 32 and the open-ended cuffs 24 are then releasably secured tightly around the wrists of the patient. In specific cases when the patient is paralyzed or the like. the open-ended cuffs 24 provide the sole means of attaching die flexible elongate strap members [6, 18 to the arms ofthe patient.

As mentioned above, the winding mechanism 20 functions to pull the ends of the flexible elongate strap members l6, l8 toward the footrest. Specifically, the winding mechanism 20 includes a shaft 34 journaled to the support 12 between upper and lower blocks 36, 38. The shaft has a square cross section, for reasons explained below. TEach end of the shaft is journaled to the blocks 36, 38 by a cylindrical bearing 40 anchored within a bore 42 in each block. A rachet wheel 44 is connected to the shaft for rotation therewith. The wheel has a square central opening 46 similar to the cross section of the shaft which relationship functions to key the ratchet wheel to the shaft. The winding mechanism further includes a ratchet crank 48 journaled to the shaft 34 for rotation about the shaft. The ratchet crank has a pawl 50 pivoted thereto which engages the ratchet wheel 44 for rotating the wheel and shaft when the crank is manipulated.

As shown in FIG. 6, when the ratchet crank 48 is moved in a clockwise direction, the pawl 50 engages the ratchet wheel 44 which causes the shaft 34 to rotate in a clockwise direction with the ratchet crank. n the other hand, when the ratchet crank 48 is moved in a counterclockwise direction, the pawl simply slides across the surface of the ratchet wheel 44 which causes the ratchet wheel and the shaft 34 to remain stationary. A coil spring 52 reacts between the ratchet crank 48 and pawl 50 for biasing the wheel engaging end of the pawl into engagement with the ratchet wheel 44. As shown best in FIG. 4, a clip 54 connected to the ratchet crank 48 may be snapped over the outer end of pawl 50 to hold the wheel-engaging end of the pawl out of engagement with the ratchet wheel 44.

The positioning device It] also includes a releasable locking assembly 56 which functions to prevent rotation of the shaft 34 in a direction opposite to the direction the shaft is rotated by the ratchet crank 48. Basically, the release locking assembly 56 operates to prevent withdrawal of the flexible elongate strap members 16, 18 from the support 12 when the locking assembly is engaged. This assembly includes a second ratchet wheel 58 connected to the shaft 34 for rotation therewith. As in die case of the first ratchet wheel, the wheel 58 has a central opening 60 which conforms to the cross section of the shaft. A portion of a ratchet crank 62 is journaled to the shaft 34 adjacent the second ratchet wheel 58. The ratchet crank portion 62 is made stationary by anchoring it to the lower block 38 of the support l2 by a fastener 64. A stationary pawl 66 is pivoted to the ratchet crank portion 62 so that one end of the pawl engages the second ratchet wheel 58. A coil spring 68 reacts between the stationary pawl 66 and the ratchet crank portion 62 for urging the wheel-engaging end of the pawl into contact with the second ratchet wheel 58. The relationship of the second ratchet wheel and the stationary pawl is such that rotation of the shaft 34 is only permitted in the direction the ratchet crank 48 rotates the shaft. in other words, when the ratchet crank 48 is moved in a counterclockwise direction, as viewed in FIGS. 4 and 6, the shaft 34 is prevented from rotating with the crank 48 by the locking assembly 56.

For purposes explained below, the stationary pawl 66 may be disengaged from the second ratchet wheel 58 by a release 70 in the form of a reciprocating bolt that contacts the end of the stationary pawl 66 opposite its wheel-engaging end. As shown best in FIGS. 2 and 6, when the bolt-type release 70 is urged to the left and locked in place, the left end of the bolt forces the stationary pawl to rotate in a counterclockwise direction about its pivot so that the wheel-engaging end of the pawl is spaced away from the second ratchet wheel 58.

The ends of the flexible elongate strap members l6, l8 opposite the releasable attaching structure are connected to the shaft 34 in the manner illustrated in FIG. 7. The shaft has cutouts 72 for receiving the strap ends, and fasteners 74 anchor the straps to the shaft. When the shaft 34 is rotated by the ratchet crank 48 the strap members l6, l8 wind around the shaft. Guides 76 on each side of the footrest 14 are provided for guiding the strap members l6, l8 to the shaft 34.

The positioning device [0 is made ready for use by placing the support 12 in an upright position on a flat surface so the operator is facing the winding mechanism 22. The clip release 54 is then moved over the pawl 50 to position the wheel-engaging end of the pawl out of contact with the ratchet wheel 44. Next, the wheel-engaging end of the stationary pawl 66 is positioned out of engagement with the ratchet wheel 58 by shifting the bolt release 70 to the left, as viewed in FIGS. 2 and 6, and locking it at that position. This operation disengages the shaft 34 from the ratchets of the winding mechanism 22 and the locking assembly 56. The flexible elongate strap members l6, 18 are then free to unravel from their wound positions on the shaft 34. The handholds 32 at the free ends of the strap members l6, 18 are grasped to facilitate the unraveling operation.

The next step in the procedure involves locating the positioning device 10 at the feet of the patient so that the strap members l6, is are parallel to the patients legs and the patients feet engage the footrest 14 of the support 12. The patient then grasps the handholds 32 and the operator fastens the open-ended cuffs 24 around the wrists of the patient. The cuffs are tightly held around the wrists by the Velcro fasteners 28. After the strap members l6, 18 are attached to the wrists of the patient the clip release 54 is moved away from the pawl 50 which causes the coil spring 52 to urge the wheel-engaging end of the pawl into contact with the ratchet wheel 44. The bolt-type release 70 is shifted to the right, as viewed in FIGS. 2 and 6, which cause the coil spring 68 to urge the pawl 66 into engagement with the ratchet wheel 58. Finally, the operator proceeds to pull the patients arms downwardly toward the footrest 14 by operating the ratchet crank 48 from right to left, as viewed in FIGS. 2 and 6. The crank is repeatedly operated in this manner until the shoulders of the patient are down out of the cervical field. The operator then leaves the radiographic room during X-ray exposure and the lateral radiograph of the cervical spine is taken. Positioning the patient in this manner enables the operator to take a lateral radiograph of the complete cervical spine including all seven vertebrae and spinous processes.

The positioning device 10 is released from the patient by first disengaging the locking assembly 56 while holding the ratchet crank 48 at a center position. The ratchet crank is then moved from left to right, as viewed in FIGS. 2 and 6, which releases the tension on the flexible elongate strap members l6, 18. Such movement of the ratchet crank 48 when the locking assembly is disengaged causes the strap members l6, 18 to unwind from the shaft 34. The release clip 54 is then positioned to disengage the pawl 50 from the ratchet wheel 44. The strap members become slack for easy removal from the patient. After the release mechanisms are moved away from the pawls the strap members can be wound around the shaft 34 for storage purposes.

What is claimed is:

l. A device for positioning the shoulders of a patient downwardly away from the neck area to facilitate unob structed X-ray examination of the cervical spine comprising support means including a substantially flat body member supporting plate, a pair of flexible elongate members each connected at one end thereof to the support means, releasable attaching means at the free end of each flexible elongate member for releasably attaching the member to the arms of the patient, winding means on the back of the body member supporting plate connected to the flexible elongate members for pulling the free end of each member toward the supporting plate, and a releasable locking assembly associated with the winding means that prevents withdrawal of the flexible elongate members away from the support means when the locking assembly is engaged wherein the winding means includes a shaft journaled to the back of the body member supporting plate, a ratchet wheel connected to the shaft for rotation therewith, a ratchet crank journaled to the shaft, and a pawl attached to the ratchet crank engaging the ratchet wheel for rotating the wheel and shaft when the crank is manipulated, and the flexible elongate members being connected to the shaft whereby rotation of the shaft through manipulation of the ratchet crank causes the members to wind around the shaft.

2. A positioning device as in claim 1 wherein the releasable attaching means at the free end of each flexible elongate member includes an open-ended cuff with fastening structure on the open end portions of the cuff for releasably securing the cuff to the arm of the patient.

3. A positioning device as in claim 2 including a handheld secured to each flexible elongate member adjacent the free end thereof.

4. A positioning device as in claim I wherein the releasable locking assembly includes a second ratchet wheel connected to the shaft for rotation therewith, a stationary pawl biased into engagement with the second ratchet wheel for permitting rotation of the shafi only in the direction the crank rotates the shaft when the locking assembly is engaged, and a release for disengaging the stationary pawl from the second ratchet wheel when the release is engaged.

5. A positioning device as in claim 4 wherein the winding means further includes a release element connected to the ratchet crank for disengaging the pawl of the winding means from the ratchet wheel when the release element is engaged. 

1. A device for positioning the shoulders of a patient downwardly away from the neck area to facilitate unobstructed Xray examination of the cervical spine comprising support means including a substantially flat body member supporting plate, a pair of flexible elongate members each connected at one end thereof to the support means, releasable attaching means at the free end of each flexible elongate member for releasably attaching the member to the arms of the patient, winding means on the back of the body member supporting plate connected to the flexible elongate members for pulling the free end of each member toward the supporting plate, and a releasable locking assembly associated with the winding means that prevents withdrawal of the flexible elongate members away from the support means when the locking assembly is engaged wherein the winding means includes a shaft journaled to the back of the body member supporting plate, a ratchet wheel connected to the shaft for rotation therewith, a ratchet crank journaled to the shaft, and a pawl attached to the ratchet crank engaging the ratchet wheel for rotating the wheel and shaft when the crank is manipulated, and the flexible elongate members being connected to the shaft whereby rotation of the shaft through manipulation of the ratchet crank causes the members to wind around the shaft.
 2. A positioning device as in claim 1 wherein the releasable attaching means at the free end of each flexible elongate member includes an open-ended cuff with fastening structure on the open end portions of the cuff for releasably securing the cuff to the arm of the patient.
 3. A positioning device as in claim 2 including a handhold secured to each flexible elongate member adjacent the free end thereof.
 4. A positioning device as in claim 1 wherein the releasable locking assembly includes a second ratchet wheel connected to the shaft for rotation therewith, a stationary pawl biased into engagement with the second ratchet wheel for permitting rotation of the shaft only in the direction the crank rotates the shaft when the locking assembly is engaged, and a release for disengaging the stationary pawl from the second ratchet wheel when the release is engaged.
 5. A positioning device as in claim 4 wherein the winding means further includes a release element connected to the ratchet crank for disengaging the pawl of the winding means from the ratchet wheel when the release element is engaged. 